The Intervention Projects of the Case Western Reserve University (CWRU) OAIC offer a unique collaboration among investigators in Geriatric Medicine, Sociology, Nursing, General Medicine, Epidemiology and Biostatistics at CWRU to address problems of critical importance to the functional well being of aging persons in acute hospital and long term care settings, and provide opportunities for research training of junior faculty and fellows. It will be directed by Dr. Jerome Kowal, Director of the CWRU Geriatric CARE Center, with the support of Drs. Amasa B. Ford and Eva Kahana. Our proposal focuses on two collaborative interventional programs of research: The first interventional study, IS A: Preventing functional Decline of Hospitalized Older Patients (S. Landefeld, P.I.), deals comprehensively with nurse-initiated interventions to minimize or prevent the deterioration of function associated with acute care hospitalization of a functional older person. An Acute Care Unit for the Elderly integrates the expertise of diverse professional caregivers in both hospital and home settings and provides systematic, reproducible and generalizable approaches to evaluating those at risk, and interventions to prevent their deterioration. The nursing initiatives and assessment measurements will also be translated to home care following hospitalization. The second area IDS A: Nursing Practice Models and Nursing Home Resident Outcomes (T. Zurikowski, P.I.) takes an innovative approach to understanding quality of care in nursing homes by offering a conceptual and measurable strategy of nursing practice models (NPMs), and considers their value in providing a framework for the design and delivery of care to elderly nursing home residents. The salient dimensions of the NPM in long-term care will be used to develop measurement strategies for each dimension, combining them to an index of NPMs, which may then be used to study the effects of NPM configuration on resident outcomes, and appropriate NPMs for nursing homes. The pilot project program will enable us to significantly expand successful locally funded programs, and focus support on projects potentially expandable to full scale intervention studies. The junior faculty development program will initially offer protected research time and training for two outstanding junior faculty with firm commitments to academic careers in aging. Gary Rosenthal, MD is a graduate of our fellowship program and Ronald Hammond, Ph.D. is a graduate of Dr. Kahana's NIA Research Training Program. The major component of our didactic training program will be the Faculty Development Training in Geriatric Clinical Care Research program, which will offer a six month curriculum in clinical, epidemiological and health services research, biostatistics and cost-benefit analysis, as well as relevant courses in social gerontology for interested junior faculty, fellows and other professionals.